Human resource requirements


Number of patients × Annual per-patient time for service delivery requirement



Provider time available to spend with patients each year

The paper is organized as follows. First, the paper outlines the estimation approach and discusses methodological issues related to coverage targets for VCT and OI treatment. Second, it presents the results with respect to two major scenarios, discusses Zambia as a specific country example, and also addresses issues of sustainability. Finally, the paper offers concluding remarks and proposed next steps.


Estimation Approach

The basic calculation undertaken in this paper is to estimate human resource requirements by multiplying the number of patients receiving care by the per-patient time requirements for service delivery, and then dividing by the amount of time that each health worker can spend seeing patients in a year. This is shown in Box E-1. The provision of VCT and OI treatment is also included in the calculations. The result is then compared to the current stock of health workers available in each country.3 This subsection provides a short discussion of each of the inputs to this equation.

The key variable underlying the number of health personnel required to achieve the PEPFAR treatment goal will be how long different categories of workers spend with each ARV patient to deliver services. In broad terms, the identification of time requirements must balance the limited available


The allocation of the 2 million patient target across the 14 countries has not yet been identified under PEPFAR. (Note also that at the time of writing, a 15th PEPFAR country had yet to be identified). It will be assumed here that each country will contribute to the overall target using the number of HIV-infected adults as the weight (data were drawn from Appendix E of the PEPFAR strategy paper [2004]). For example, a country accounting for 10 percent of all HIV infections in the 14 countries would have a target to treat 200,000 of the 2 million patient total. Of course it is unlikely to be this simple in practice, and indeed the issue of human resource constraints is arguably a reason unto itself for expanding services more rapidly in some countries than in others.

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